Jun 27, 2019 • Longeviti

So Where Did All the Independent Doctors Go?

We’ve lost too many independent primary care and family practice physicians. But, for those fortunate practitioners who have remained in private practice, there are some new and attractive opportunities at hand.

So where did all the independent doctors go? Many chose to retire. Why? 

  • Primary care physicians receive only 2/3 to 1/2 the compensation of other specialists
  • Seeing 35+ patients per day makes it challenging to have both pride in one’s standard of care and sufficient “personal time”
  • Increasingly burdensome government regulation and insurance billing/administration
  • EMR’s  (Electronic Medical Records systems) that only seem to add complexity, taking precious time away from patients.
  • The expense of operating an independent practice
  • The realization that practices, built over decades, have little value as a retirement asset. (NOT TRUE!).
  • Concern over competition from Urgent Cares and hospital-based primary care

Learn the “all weather” strategies used by successful private primary care and family medicine practices to improve profits and enhance physician satisfaction (Link)

Many physicians trade away their independent practices (and their patients) to join hospital-based primary care group practices promising:   

  • 9 to 5 workdays:
  • Freedom from all of the management burdens of private practice.
  • Adequate salaries, guaranteed by contract

In doing so, they generally receive little from the hospitals (no $$$) in exchange for both their practices and an extremely valuable non-compete agreement (insisted upon by the hospital for the purpose of limiting the rights of the physician to re-start their practice should they “separate” from the hospital for any reason).

Physicians who work at hospitals are just that; hospital employees

As employees, physicians are subject to performance reviews by financial managers, whose primary concern is the profit generated by physicians. Should “accountants” decide that a given physician is “not making his numbers,” that “job,” like that of any under-performing employee, is imperiled!

The hospital, now in “possession” of the patients from the physician’s previous practice, has:

  •  no incentive to continue to employ the physician beyond their original contract, profitable or not.
  • every incentive to replace the relatively expensive physician with less “expensive” NP’s or PA’s, able to see more patients at lower cost

More tragic is that physicians who are “let go,” no longer have their patients or Practice to which they can return (that non-compete agreement!)

Conflicts and Contradictions

In the pursuit of hospitals’ profits, physician-employees may be strongly encouraged to:  

  • see as many patients as possible (ironically like the 35+ patients daily the physician may have seen in their private practice)
  • direct patients to the hospital’s “high-margin” services as opposed to less expensive alternatives without regard to the interests of the patients
  • do the above while avoiding any financial liabilities that might threaten the interests of the hospital

There are better alternatives!

The political uncertainty over the future of healthcare and the pressures of operating an independent primary care/family medicine practice can only increase.

For physicians who enjoy practicing medicine and can adapt while there is still time, there are much more attractive options vs. retiring or giving a life’s work away for the “privilege” of punching a clock as a hospital employee.

Learn the “all weather” strategies used by successful private primary care and family medicine practices to improve profits and enhance physician satisfaction (link)


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